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Purpose: The study evaluated work experience changes and its determinants after return to work (RTW) in angioplasty or heart surgery patients., Methods: During a 1-year period (2014) in a Rehabilitation Hospital in northwestern Italy, we approached 253 patients (19.3% of inpatients). 199 patients consented to complete a survey on job characteristics, job satisfaction, job involvement, illness perception, depression, anxiety, adherence to therapy, and sociodemographic characteristics. The data were analysed with paired sample t tests and random intercept regression models., Results: 156 patients completed both the baseline and the 6-month follow-up assessments. After 6 months, 137 (88%) patients return to work (86% male, M age = 51.9 ± 8.1). The patients predominantly underwent angioplasty/bypass (46%) or valve replacement/repair (38%). Work hours (WO), job satisfaction (JS), and job involvement (JI) significantly decreased after RTW (WO: t (132)  = 2.07, p < 0.05; JS: t (134)  = 2.56, p < 0.05; JI: t (129)  = 4.14, p < 0.001). The decrease in work hours over time was associated with a within-subjects decrease in psychological job demands (β = 5.107, t (112.1 ) = 2.21, p < 0.05) and job satisfaction (β = 2.498, t (112.92)  = 2.265, p < 0.05) and an increase in physical job demands (β = - 1.314, t (112.07)  = - 2.416, p < 0.05). The decrease in job satisfaction over time was related to a within-subjects decrease in decision latitude (β = 0.505, t (116.43)  = 2.825, p < 0.01) and an increase in psychological job demand (β = - 0.586, t (116.78)  = - 3.141, p < 0.01). The decrease in job involvement over time was associated with a decrease in physical job demands (β = 0.063, t (117.19 ) = 2.157, p < 0.05) within-subjects., Conclusions: The study showed that many patients who RTW after angioplasty or heart surgery have poorer work experiences relative to changes in psychological and physical demands and more passive roles.